Amputations in Kenya

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Retrospective study

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Amputations in Kenya

  1. 1. AMPUTATION AS SEEN IN AN ORTHOPAEDIC WARD IN KENYA Were ID; Mutiso VM; Ating’a JEO; Otsyeno FMT Affiliation KNH/UON/AORF
  2. 2. Introduction • Amputation is a psychological, social and economic tragedy for the patient and his/her family. • In an environment where rehabilitation facilities are not well developed, the operation becomes a dreaded procedure Indications – Vascular Disease and Diabetes – Trauma – Frostbite – Tumors – Congenital
  3. 3. Subjects & Methods • This study aimed at ascertaining the patterns of lower limb amputation at Kenyatta National Hospital with regards to indications for surgery and levels. • Review of all cases of lower limb amputations done in Firm III Orthopaedics at Kenyatta National Hospital over a six weeks period between 15th February 2013 and 31st March was done
  4. 4. Results • There were 15 cases available for study 13 eventually being enrolled • Two refused to give consent for the study • The age range was 26 to 72 years, mean age of 41.2 ± 10.6 years • The male:female ratio was 2:1 • Of the two patients who refused to give consent the diagnosis was tumor in one the other was a mangled extremity. • Time taken to get consent ranged between two days and eleven days with an average of 5 days. • The level of amputation appeared to have been governed by the pathology. • One patient with diabetic foot who underwent below knee amputation had to undergo above knee revision amputation.
  5. 5. Figure 1: Graph showing type of amputations in % 69.2 30.8 Trans-tibial amputation Trans-femoral amputation POPULATION IN % TYPE OF AMPUTATION TYPE OF AMPUTATIONS
  6. 6. Figure 2: graph showing indications for amputation in % 53.8 23.1 7.7 7.7 7.7 DIABETIC FOOT GANGRENE TUMOUR INFECTION TRAUMA FROST BITE Population in % INDICATIONS INDICATIONS FOR AMPUTATION
  7. 7. Figure 3: Graph showing distribution of patients who underwent amputation by age 0 0 2 2 4 5 Newborn 2wks-5yrs 6-12yrs 13-24yrs 25-59yrs >60yrs No. of Patients Life cycle cohort Ages of Patients
  8. 8. Conclusions • The elderly patients(>60yrs) constitute more than 30% of amputees, consequent to Diabetic gangrene foot. • Patient education, counselling and establishment of rehabilitation programs for children are recommended
  9. 9. References • Awori KO, Atinga JEO. Lower limb amputations at the Kenyatta National Hospital. Nairobi East Afr Med J 2007;84:121–126 • Ogeng'o JA, Obimbo MM, King'ori J. Pattern of limb amputation in a Kenyan rural hospital. Int Orth 2009;33:1449–1453

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